Critical Decision- New Grad (Please Help)

Nurses General Nursing

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Please help, I have a big decision to make.

Background- Just graduated in May with an ADN, passed NCLEX. Enrolled in an RN to BSN expecting to complete it in 6 months. Past experience; CNA for 9 months before I was laid off and currently working as a hha. I Have applied to hospitals with no interviews. I did get interest from 1 hospital; reviews said it was a great teaching hospital and I would have my choice of what unit, but I would have to relocate there and stay for a year or two and the pay is quite low (Bassett Medical Center in Cooperstown- always hiring new grads if anyone is interested)

My dilemma- I applied to a couple of long term care facilities and got a quick response. Within hours of sending in my application, the agency is sending me on an interview tomorrow and they want me to send all the forms and paperwork in by Monday, because the facility has orientation starting Tuesday. From how they are talking to me it sounds like I have the job if I want it. Do I accept? I am torn because this is such a crucial decision. Nursing is my life and the first new grad job is so key.

Pros- Good pay, facility is really close to my home, can potentially give me that needed experience I need if I eventually want to work in an acute setting.

Cons- The RN to patient ratio is 1:30. I'd be starting with 30 patients as a new grad, I never even had more than 2 during my school clinicals! The recruiter/agent told me that their company hires RNs all the time at this specific facility and most people transition smoothly. She said the first couple weeks will be tough but I'll eventually manage, unless I'm just slow. I'm not sure if I should believe her, she has every incentive to make the job sound as appealing as possible. I've done research on new grads working LTC and it sounds like it's really hard work. I'm not sure if I have the personality to be thrown into the fire like that, I was hoping to be eased into a role. I have always been a bit on the less assertive/quiet side. I'm very willing and understand it's actually necessary to change, but being thrown in like this is worrying if I can handle it.

Should I just accept the job and if I find a facility with lower nurse/patient ratios, just jump into that instead, so I have a better chance? Should I stall, see if I can find a better LTC position or even get lucky and land a hospital position? What would you do if you were me?

Thank you in advance for your help, I am greatly looking forward to all your advice.

Would relocation be a hardship for you? The hospital opportunity sounds pretty good if you can swing the move.

Ask yourself WHY the SNF is hiring a new grad.. it's because more experienced nurses won't accept the role. You are spot on that the recruiter just wants the finder's fee and could care LESS about your career goals and license.

As an agency nurse, I tried a few SNF shifts. Even with many years of experience... I could barely keep us with the med passes for 30 residents. You will be pushing pills and overseeing CNA's... responsible for the residents and the assistant's care.

Best of luck whatever you choose.. let us know how it turned out.

Thank you, your comment has really put things in perspective. All day I have been leaning towards taking the offer and making the most of it but now I am reconsidering. Thank you again.

Anyone else have any ideas or opinions? Would love to hear them

30 patients is on the better end of things for SNF/LTC. Yes you only had 2 patients in school and you would definitely have less patients in a setting like med-surg or ICU; however, of those 30 patients you have, how many will you need to attend to for more than medication administration? As you get to know your patients, each med run becomes faster and you'll realize the luxury of such a setting.

Thanks a lot for your post. I'm un-reconsidering now!

Okay good points. I suppose meds does get quicker once you know the patients routine. I didn't realize 30 was a good ratio even for LTC/SNF so I'll take that as a positive. The few reviews I read on indeed and glassdooor the RN's seemed to like working there.

Would the night shift be better if I took this position? I have no problem with nights but I'm not sure if I would have a greater patient load then.

I'm interviewing today so I will ask them many questions to get as much info as possible. I think I will pass, as badly as I want to start working, and look to see if something better/ more manageable comes along.

Specializes in Ambulatory Care-Family Medicine.

I worked LTC as a new grad. The first few shifts are horrible until you find your rhythm, so just be prepared for that. LTC is not for everyone (just like L&D, ER, ICU, etc are not for everyone). There no way to tell you if you will like it or if you can keep up until you give it a shot. Just remember there are some bad LTC where you have to worry about your license and some really good ones. Read the reviews online from families, that'll give you a glimpse of how this one is.

However, if you can swing the move that would be my first choice as it sounds like a better learning opportunity for a new grad.

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